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    Posted: 06 November 2009 at 2:48pm
So, over the past couple of healthcare threads, I have stood strongly by what is basically the party line for the pro-socialized medicine crowd:  The US healthcare system is really bad, and we could get more for less with nationalized care.  Evidence of this found, among other places, in the lower life expectancy and higher infant mortality for Americans than Europeans.
 
oldpbnoob (and others, but most consistently pbnoob) has objected to this claim, correctly noting that there are many factors that go into life expectancy/infant mortality, and that in any case those may not be the best or only measures of the quality of a healthcare system.
 
These exchanges have made me rethink what does make a quality healthare system make, and it is a complicated picture.
 
I thus pose to our brain trust:  What makes one healthcare system better than another?  Can one system ever even be simply "better"?
 
To add information, I suggest reading this op-ed piece:   http://www.nytimes.com/2009/11/05/opinion/05kristof.html?_r=1&em 
 
Some interesting stats are listed, with links to some studies.  It is an opinion piece, so read accordingly, of course.
 
Thoughts and/or opinions?  Is the US healthcare system better or worse than the Canadian/British/French/Ugandan healthcare system?
 
 

"E Pluribus Unum" does not mean "Every man for himself".

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Post Options Post Options   Thanks (0) Thanks(0)   Quote __sneaky__ Quote  Post ReplyReply Direct Link To This Post Posted: 06 November 2009 at 2:52pm

I see this thread ending well.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Peter Parker Quote  Post ReplyReply Direct Link To This Post Posted: 06 November 2009 at 2:54pm
Originally posted by __sneaky__ __sneaky__ wrote:

I see this thread ending well.

 
Hopefully we will get a couple of pages of discussion on how to measure healthcare systems before it detereorates into zomg socialism.

"E Pluribus Unum" does not mean "Every man for himself".

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Post Options Post Options   Thanks (0) Thanks(0)   Quote oldpbnoob Quote  Post ReplyReply Direct Link To This Post Posted: 06 November 2009 at 2:54pm
Originally posted by Peter Parker Peter Parker wrote:

 
I thus pose to our brain trust:  What makes one healthcare system better than another?  Can one system ever even be simply "better"?  
Overall health consciousness, and willingness to adhere to a healthier lifestyle, of it's participants. Also, being less ethnically diverse seems to be a helping factor.  But this probably speaks more for the reason for the successful results of one system over another rather than the actual system.
 
And you can call me OPBN if you prefer to save some finger strokes.


Edited by oldpbnoob - 06 November 2009 at 2:58pm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote __sneaky__ Quote  Post ReplyReply Direct Link To This Post Posted: 06 November 2009 at 2:55pm
Depends when FE logs in next, really.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Benjichang Quote  Post ReplyReply Direct Link To This Post Posted: 06 November 2009 at 3:00pm
I really think part of the problem lies deeper than our healthcare system and it's flaws, and it seems that the article touches on it a bit- Americans, it seems to me, often have an attitude that the way we do things and what we have is the best in the world, and we never look beyond that.

When you look at the facts and statistics, as this article points out, we are lagging behind the rest of the industrialized world. I don't really have anything to say that hasn't been said on here dozens of other times. I just wish people would acknowledge that things are amiss instead of trumpeting how we have the best healthcare in the world, etc. Our system really is broken, and millions of people are left without adequate access to care because of it, and it's costing us too much money right now.

Most of my friends don't have health insurance. I'd really hate to see what would happen to them if serious injury or illness befell them.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Peter Parker Quote  Post ReplyReply Direct Link To This Post Posted: 06 November 2009 at 3:00pm
Originally posted by oldpbnoob oldpbnoob wrote:

Originally posted by Peter Parker Peter Parker wrote:

 
I thus pose to our brain trust:  What makes one healthcare system better than another?  Can one system ever even be simply "better"?  
Overall health consciousness, and willingness to adhere to a healthier lifestyle, of it's participants. Also, being less ethnically diverse seems to be a helping factor.
 
 
I guess I was wondering about the other end of "what" - not so much the factors contributing to health, but what measures we should use when determining whether a system is successful or not.
 
For instance, all other things being equal, healthcare system A would be "better" than healthcare system B if the life expectancy were higher under A.  But since all other things are not equal, life expectancy is marred as a measure (still a worthwhile goal and useful measure, just not a sufficient measure).
 
What are some good measures of how a system is doing?
 

"E Pluribus Unum" does not mean "Every man for himself".

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Post Options Post Options   Thanks (0) Thanks(0)   Quote carl_the_sniper Quote  Post ReplyReply Direct Link To This Post Posted: 06 November 2009 at 3:02pm

Coverage. 

A healthcare system that only covers 10% of the population, even if it gives them the best possible healthcare, is still a terrible system.


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Enos Shenk Quote  Post ReplyReply Direct Link To This Post Posted: 06 November 2009 at 3:24pm
For me its real simple. Government has only a very few legitimate functions. Caring for the citizens is one of those. Since this whole thing started, Ive been at an utter loss as to why the conservatives are so against basic human rights type things like caring for sick people.


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Post Options Post Options   Thanks (0) Thanks(0)   Quote oldsoldier Quote  Post ReplyReply Direct Link To This Post Posted: 06 November 2009 at 3:58pm
One of the contributing factors in our infant mortality rate is age. American women are having children later and later into thier lifecycle, and want that child delievered based on their schedule (the women in the workforce are the primaries here). Not being good in biology but having a female Socialology Proffessor making the claim that the prime child rearing age is between 14 and 20, and American proffesional woman are waiting till late thirties/early forties with all the medical issues therein.

It does seem interesting that most hospitals prior to 1964 were funded by the various 'churches' and though not profit monsters held thier own even during the depression. Yet the government gets involved with Medicare and Medicaid and they are financial circuses now. And now we want the government more involved , and avoid any potential of 'donation' hospitals. The Best Child Care Hospitals in the World are private donation funded Shriner's Hospitals and St. Jude in Memphis (Danny Thomasd Foundation), each refusing any government interference for there will be strings attached.

Caring for your fellow man, in the biblical sense is ensuring that your fellow man is prepared to care for himself. Give a man a fish he eats for a day, teach him to fish he eats for life. But too many her frown on any biblical reference. And the current preference is to give the individual a rationed amount of fish, so everyone shares in the limited supply.

Edited by oldsoldier - 06 November 2009 at 4:00pm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote FreeEnterprise Quote  Post ReplyReply Direct Link To This Post Posted: 06 November 2009 at 4:10pm
Maybe because the only thing government intervention has ever done is to raise costs.
 
Be it taxes, prices or anything else. Look at farming. I live surrounded by farmland, some of it the farmers are payed NOT to farm...
 
yeah, thats logical, all to keep the prices high artificially.
 
Now they want to control health care, I think it will make the prices higher, by looking at medicare and medicade.
 
 
 
 
 
What is good healthcare,
 
easily accessable, and very high skill level of surgeons. I don't want the guy with the "lowest bid" doing my brain surgery should I ever need it.
 
I want the Best in the field, who has an amazing track record of success. And to get that I have to pay more, I get that, do you watch minor league sports?... Most don't, they PAY MORE to watch quality.
 
But, I'm sure many think the lowest price is much better in healthcare...
 
 
I also think that if you want good health care, the doctors need to be protected from frivolous lawsuits that just drive up the cost of care.
 
I also see "good" healthcare that rewards good practices. If you don't smoke drink or live promiscous lives you should pay less than people who do for your coverage.
 
Hospitals were founded by the religious members of society to help the poor, its sad that the common thought is religious members of society don't care... When the facts say otherwise. This afternoon I was over talking to one of the best eye surgeons in the world, he gives TONS of money, and time to worthy causes. Not because the government forces him to, but because of his belief in helping others.
 
He also has told me of the many things he has had to do outside of the country because of our excessive restrictions on "cutting edge" procedures. As someone who has revolutionized eye surgery, he knows what the problems are, and getting the government more involved will just reduce our countries ability to lead in healthcare as we have done for generations.
 
The best doctors will leave the US to go where they can make the money they deserve to make from their hard work and dedication.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote choopie911 Quote  Post ReplyReply Direct Link To This Post Posted: 06 November 2009 at 4:15pm
Isn't there already a ranking system in place for which countries provide the best healthcare? When facts are slapping you in the face (in general, not you FE, Im just below your post) why is it so hard to see what they're doing and consider how you could apply it to yourself. Yes I know the system in countries like Norway would NEVER work in the US even just because of population, but you've got to start somewhere.
The current system is crap.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote oldpbnoob Quote  Post ReplyReply Direct Link To This Post Posted: 06 November 2009 at 4:44pm
Originally posted by choopie911 choopie911 wrote:

Isn't there already a ranking system in place for which countries provide the best healthcare? When facts are slapping you in the face (in general, not you FE, Im just below your post) why is it so hard to see what they're doing and consider how you could apply it to yourself. Yes I know the system in countries like Norway would NEVER work in the US even just because of population, but you've got to start somewhere.
The current system is crap.
But that is the crux of the argument. Is our system actually crap? Or is our system actually doing really well considering that we are a society of overindulgence, I.e fat, lazy, 2 pack a day smoking lumps of goo? Sure, if we were a society of intelligent, Scandinavians, with little ethnic diversity and a lifestyle that centered around healthy living and excercise, our life expectancy should and would be higher. Our cost per person to acheive the same life expectancy, infant mortality rates etc would be significantly less than they are now. Other industrialized nations are not having to fight the same battles we do, because they do not necessarily exist within those cultures. A few points; infant mortality rates within the U.S. are significantly higher among minoriites, thus making ours seem considerably higher than what they are. Mainly attributable to low average birthweights among other things. Mortality rates due to heart disease are higher in some male ethnic minorities than others again skewing the figures. Comparing our health against those of other countries is nearly like comparing apples to french fries. It isn't so much as what we are comparing as it is what we are not taking into consideration.  You can't compare the life expectancy rate of an inner city hispanic male that lives off of McD's and Coke with that of a Norwegian who cycles 200 miles a week and eats mostly unprocessed foods and drinks water.
 
So I guess my answer to Peter is, we are using the right points, just not analyzing them or weighting them correctly.
 
A thought actually came to me and I may ramble a bit trying to express it, but I thought that part of my aggravation with the proposed system is not that it will cover more people, but that it will cost me more money. My fear is that without changing our lifestyles, that we are on a road that can never see a decrease in our insurance costs. It will continue to escalate the fatter, less healthy we get. What if we were to adopt a system that rewarded good health and punished poor health? How about a fat tax so to speak? You pay on a sliding scale depending on how much you weigh in relation to your height, age etc.? Smokers are given one year to quit. If after that year, if they don't quit, any costs related to lung disease or any other smoking induced illnesses are no longer covered. Essentially, if you smoke and refuse to quit, if you get sick, you die? Make people responsible for their actions. How about universal health cards? Used kind of like a credit card. If you go to the gym and run 3 miles, you get a discount on your health insurance. Issue walkmeters on people and if they walk/run a certain distance, they get more of a discount. Further, people that refuse to excercise or lose weight get penalized through significantly higher rates. As I see it one of the only ways to hurt Americans is through their wallets and if it starts costing you money to be unhealthy, you will change. Look what happened when fuel prices shot through the roof. Suddenly people are looking at smaller, more gas efficient cars. Now that gas prices are down now one cares. If you are rich, want to be fat and pay for it, so be it, but it would encourage those that want to pay less, to do so by living a healthy lifestyle. We could get even more big brother and tax people for unhealthy foods. You want to buy a HoHo or DingDong, you get a 30% luxury tax on that item. You want to smoke em up, a pack of cigs will cost you $10, most of which is tax. Any health system whether current or proposed, will never truly be successful without changing the way we treat our bodies.
 
I don't think that our government in it's current state is even remotely capable of coming up with a system that could accomplish the task of changing our attitudes toward health. Last thing I want to do it keep paying (we can argue that later) for the healthcare I have  and than have to pay more in taxes to pay for everyone else. If we could come up with a system that made us healthier as a nation , we could reduce costs per person and spend the same money and get insurance for everyone. I don't really have a problem with covering more people, I just really don't want to pay more to do so.


Edited by oldpbnoob - 06 November 2009 at 4:50pm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Peter Parker Quote  Post ReplyReply Direct Link To This Post Posted: 06 November 2009 at 4:48pm
Originally posted by FreeEnterprise FreeEnterprise wrote:

 
 
What is good healthcare,
 
easily accessable, and very high skill level of surgeons. I don't want the guy with the "lowest bid" doing my brain surgery should I ever need it.
 
I want the Best in the field, who has an amazing track record of success. And to get that I have to pay more,
 
I think there is a fair amount of agreement about what good healthcare is, FE (although certainly not complete agreement) - my question is not about that, but about what is means to be a good healthcare SYSTEM.
 
 

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Post Options Post Options   Thanks (0) Thanks(0)   Quote oldsoldier Quote  Post ReplyReply Direct Link To This Post Posted: 06 November 2009 at 4:56pm
In a fiscal sence, providing health care for a nation of 90million is a lot differant than providing healthcare for a nation of 390million. Lete look back, In the old Soviet Union, there was universal health care available to everyone (abiet two tiered the Party and the People levels), Yet many traveled from the Soviet Union to East Germany to recieve 'quality' care. The German work ethic trumped the true Soviet ethics, so a better service was provided than they could recieve by Soviet Doctors.

Now a lot of 'universal' care system patients come to the US for more intensive care, than they could recieve in a timely fashion within thier own system.

And the comment made on the new system where the question asked is: why 'waste' assets on the aged or life ending diseases where patient care only prolongs life for a time frame that does not equate to a proper fiscal formula. That in itself is contrary to the oath Doctors take of do no harm.

The current system works to the extent it is designed to, the contributing factors such as trial lawyers sueing if a 'perfect' result is not achieved in a non-perfect science, where the lawyer recieves a high percentage of the damages, only contributes to costs. The inability of Americans to control thier personal behavior is limiting thier need for 'healthcare'. Being overweight, smoker, AID's, etc will increase since there will be no restraint and someone else foots the bill for thier bahavior anyway. Has been the failing of all 'universal' systems so far. Teddy Kennedy did not go to his local community Hospital, he went and paid for the best available, but yet backed a program that would limit your ability to do the same. No greater level of hyprocracy is needed, when the people who will force you into a system they have excempted themselves from.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Enos Shenk Quote  Post ReplyReply Direct Link To This Post Posted: 06 November 2009 at 4:56pm
Originally posted by FreeEnterprise FreeEnterprise wrote:

Maybe because the only thing government intervention has ever done is to raise costs.


So we should just not try? Attempting to change things for the better is never a mistake, even if it doesnt work out as expected.

Why does an MRI scan cost thousands and thousands of dollars? Does the government control those prices? Oh, right, thats the private sector.

As far as Im concerned, Id rather see someone make a go at helping people any day. I dont claim to have all the answers, but Ill definately say taking a shot at a solution is better than just whining and not doing anything.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Peter Parker Quote  Post ReplyReply Direct Link To This Post Posted: 06 November 2009 at 4:59pm
Originally posted by Peter Parker Peter Parker wrote:

Originally posted by __sneaky__ __sneaky__ wrote:

I see this thread ending well.

 
Hopefully we will get a couple of pages of discussion on how to measure healthcare systems before it detereorates into zomg socialism.
 
Oh well.  We almost made it one page.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote brihard Quote  Post ReplyReply Direct Link To This Post Posted: 06 November 2009 at 5:06pm
Uhm, OK, this is sort of 'stream of consciousness'.

1. Coverage. Everybody is able to access necessary care.

2. Accessibility. Individuals in need of health care are able to access it in a manner timely to their condition.

3. Thoroughness. Conditions are treated, medical situations are resolved wheresoever possible.

4. Prevention. Emphasis is placed on reducing end costs by preventative medicine that reduces or mitigates later illness. Regular cancer screening, easy access to diagnostic facilities and equipment, etc.

5. Compassion. People are patients first, and their rights, needs and concerns are respected by all parties in the healthcare system.

6 Professionalism. Medical professionals are kept to a high standard of practice and conduct.


That's my initial thoughts.


Edited by brihard - 06 November 2009 at 5:07pm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote oldpbnoob Quote  Post ReplyReply Direct Link To This Post Posted: 06 November 2009 at 5:27pm
Originally posted by Enos Shenk Enos Shenk wrote:

[QUOTE=FreeEnterprise]
Why does an MRI scan cost thousands and thousands of dollars? Does the government control those prices? Oh, right, thats the private sector.
Because the machine costs millions of dollars. The doctors do not charge for the MRI, the hospital does in order to pay for such capital improvements. But I know what you mean.
 
Also, part of the reason that doctors have to charge so much is to offset the obscene amounts of money they have to pay for malpractice insurance. Maybe our new slogan should be " reduce your healthcosts, kill a lawyer".  Or to appease FE "Avoid socialism, kill a lawyer"


Edited by oldpbnoob - 06 November 2009 at 5:27pm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote __sneaky__ Quote  Post ReplyReply Direct Link To This Post Posted: 06 November 2009 at 5:31pm
Originally posted by Peter Parker Peter Parker wrote:

Originally posted by Peter Parker Peter Parker wrote:

Originally posted by __sneaky__ __sneaky__ wrote:

I see this thread ending well.

 
Hopefully we will get a couple of pages of discussion on how to measure healthcare systems before it detereorates into zomg socialism.
 
Oh well.  We almost made it one page.
It was a good effort tho PP, I commend you for being so bold as to try to have a serious discussion on this forum again.
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